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Author Topic: When to accept it is what it is.....  (Read 3048 times)

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Offline Lyndsey

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When to accept it is what it is.....
« on: October 15, 2012, 06:14:59 PM »
Hey all, it's been a while since i've posted on the board. For those of you who don't know, I had derotational osteotomies on both my right and left femurs. Before that I had a ton of pain and instability in my knees. It's been a couple years now since I had the surgeries, and the instability is gone. Now, I can run if I want too, and not worry about my knees giving out.  :)

My issue now lies with my left hip mainly, and some pain in the left knee. I don't know why, and neither does my OS but the right leg I could run a marathon and the left still causes me pain. It's not constant like it used to be, but sometimes it gets to be really painful. My OS has redone the CT's to rule out tibial rotation, but he doesn't think it's that because the pain isn't in my left knee and my numbers aren't bad at all, only 37 degrees of rotation. I'm glad for that!

He did an MRI on both my hips to see if there was something with the left that was different from the right, but didn't find anything there either. He knows i'm not a whiner, so the pain is really there but he can't figure out what it might be. I'm just really frustrated because it really hurts sometimes, but not constantly. I think it probably at this point just is what it is. It's not like ít's pain so bad I can't deal, but it's really annoying pain because sometimes it spikes at the most inopportune times, like when i'm at work or at horse shows with clients or trying to get something done around home. It makes me miserable and stops me in my tracks, but it'll only last a day or two and then go away for a while until it hits again.

I'm still glad I had the surgery because I don't have to deal with the instablity or constant pain anymore. It's just that I guess I feel a little selfish because I don't want to have any pain anymore, and i'm frustrated because i've seemed to hit this wall that I can't get beyond.

Any advice or comments from my fellow kneegeeks???
Lyndsey
5/15/08      R femoral derotational osteotomy
1/19/09      L femoral derotational osteotomy
12/17/09  hardware removal (L&R femoral blade plates and screws)
10/28/10 removal of bone chip and cleanup of scar tissue on left
4/2014 15 deg. Re-rotation of L Femur
9/2014 L. Plate Removal & Fix Fracture

Offline Maverick

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Re: When to accept it is what it is.....
« Reply #1 on: October 15, 2012, 08:09:14 PM »
Lyndsey, glad to hear that things are a lot better with your knees but sorry you are still having issues.

Knee and hip pain can come from your back or a back injury.  Do you have back issues?  This may be an option to try out.

Best of luck to you!

1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline allyd

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Re: When to accept it is what it is.....
« Reply #2 on: October 15, 2012, 10:04:01 PM »
I was going to suggest the same thing. Maybe have your OS check out your back if your knees/hips all look clear.

And, yes – I think we all need to have that ‘come to Jesus moment’ where we are realistic what our legs/knees have been through. Perfection while great, may or may not be possible. I too admittedly have the same complex of my knee is far better off because of surgery – but I want it to be perfect, and it’s not. My OS continually drills home the – be realistic – argument. Not because she is settling, or thinks I should, or doesn’t know what the problem is, or is bored with me, or whatever excuse some might say… It is just the simple fact that a post op knee is just that, a post op knee.

I believe there is a difference between giving up and accepting. Giving up would indicate something could be done about it, Accepting is realizing it is what it is. It’s a fine line, and what that line of acceptance is for you in terms of lingering problems… Only you and your OS can answer that.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline Lyndsey

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Re: When to accept it is what it is.....
« Reply #3 on: October 15, 2012, 11:40:13 PM »
Mav, I don't have any back issues that I know of. However, I have started going to a chiropractor because we all need maintenance, especially those of us who have limped for a long time. My chiro did xrays my first appointment and he said there is some mild degeneration of the discs in my lower back, but he didn't seem really concerned about it.

Ally, you are right about the fine line between acceptance and giving up... I think at this point if I did more to try to be perfect I will end up doing more harm than good, simply because it's not awful right now.... it could always get worse, and I know what having surgery does to my body and I don't want to go through that again if I don't know it will help. There are a couple things he said we could try, but these things can lead to bigger problems. I'm just afraid to do anything else because my OS and I agree that there are some minor issues, but he doesn't know which one of those issues is causing the pain, and to rule them out would be a long and painful process that he doesn't even know will work. I'm confident that he really knows what he's doing, and if he's not sure anything else would help then I don't want to take the plunge.

As I type this it feels like someone is stabbing a hot poker through the outside of my left hip... i'm not sure whether it's the cold rainy day or what, but i'm really just so frustrated with hurting. I work midnight shift, and i'm afraid that's not helping my pain either. It's colder and I don't get any normal sleep at all.... but it's a job and i'm kind of stuck there until I can find something else, which isn't easy. I have to go to work in 2 hours and I just hope my hip stops hurting soon.  :-\
5/15/08      R femoral derotational osteotomy
1/19/09      L femoral derotational osteotomy
12/17/09  hardware removal (L&R femoral blade plates and screws)
10/28/10 removal of bone chip and cleanup of scar tissue on left
4/2014 15 deg. Re-rotation of L Femur
9/2014 L. Plate Removal & Fix Fracture

Offline Maverick

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Re: When to accept it is what it is.....
« Reply #4 on: October 15, 2012, 11:44:53 PM »
Since you are seeing a chiropractor it would not hurt to go see a back specialist.  I do know of people with sever knee pain that came from their back.  It can't hurt to check it out.

Best of luck!
1976 Arthoscopy, damaged cartilage
2007 Lateral release of the patella
2011 Meniscectomy and microfracture (grade 4)
2012 Debridement / Chondroplasty
2013 CRPS left knee

Thank you, Maverick

Offline Kwal57

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Re: When to accept it is what it is.....
« Reply #5 on: October 16, 2012, 02:03:30 AM »
two days of pain consistently out of your life is miserable. Keep looking until you can figure out what is up!!!
*Kay*
'Runners' knee > Lateral Release 3/11
Minor Meniscus tear > clip 3/11
Fall on bad knee 1/12
PT 3/12-6/12
MRI > Cartilage missing = Cortisone + PT 5/12
Arthroscopy > cartilage missing, meniscus tear, & misalignment 8/12
TTO/ACI 10/13
Healing....for now :)
instability :/

Offline Teacher2Many

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Re: When to accept it is what it is.....
« Reply #6 on: October 16, 2012, 02:50:39 AM »
Hi Lyndsey....

First, glad that you are happy with your decision to have the derotational osteotomies in the first place.  Nothing worse than doubting that decision years later.

Second, as for the pain, two things I'd suggest:

1-as others have indicated, an MRI of the back.  X-rays don't always show damage and if they are showing some disc damage, I'm contemplating if it is more significant that an MRI would show (I have herniated discs in my entire lumbar spine from L1-S1 as a result of shoveling on a really bad winter night.  X-rays kept coming back negative and finally decided to see a spine specialist who ordered an MRI and results of herniated discs were immediate.).

2-Perhaps an arthrogram of the hip is in order.  I too had the same surgery as you (along with the tibial derotational osteotomies) and had persistent left hip pain as well, even after the plates were removed.  There was some impingement going on and I saw an local hip OS who did the arthrogram which showed that I now have a labral tear.  There is also some asymmetry in my hip sockets that after the derotation, the gap between the head of the femur and the hip socket is narrower which is what causes the impingement.  And sometimes starting with a new OS with a different speciality (ie only a hip doc) helps as it's a fresh perspective who might see something that your current OS overlooks.  Second opinions do wonders-either confirm what your original OS said and therefore alleviating any doubt you have and can, potentially, find the problem that was easily missed.
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline srosky

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Re: When to accept it is what it is.....
« Reply #7 on: October 17, 2012, 06:37:38 PM »
I am so glad to find this site maybe someone can help my daughter. She is just turning 18 has had chronic and constant pain BEHIND both knees (not in front) for years. She does not sleep & we've tried so many medications. She's seeing a counselor now due to some mild depression. She was even home schooled her junior year of high school - she's missed out on a lot of things. We've been to so many doctors & tried everything from gluten free diets to acupuncture, etc. We've been to the Cleveland Clinic & once to Dr. Tietge in Michigan (we live in buffalo NY). Dr. Tietge recommended derotational osteotomies for both legs - no other doctor has agreed because the pain is behind her knees. He gave her a diagnosis of excess femoral anteversion and excess internal tibial torsion. She has marked inward pointing of knees, feet are grossly pronated and gross valgus in heels. Femoral anteversion is 70 degrees. She has a positive J sign. Is there anyone with anything like this?? Or did everyone have the pain in front of the knee? Most doctors have recommended physical therapy which has not helped. She was also diagnosed with joint hypermobility syndrome. We just don't know what to do. I don't want her to have surgery if it's not going to help. But by the same token Dr. Tietge is considered an expert... any thoughts anyone?? thanks Sue

Offline Teacher2Many

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Re: When to accept it is what it is.....
« Reply #8 on: October 18, 2012, 03:18:06 AM »
Hi Sue,

First, I am sorry to hear your daughter is going through this at such a young age.  It is not a fun road to go down that's for sure.  I've had a gammet of surgeries with the final major ones being derotational femoral and tibial osteotomies bilaterally by Dr. Teitge (done 11 months apart).  I can say that from my experience, most doctors aren't aware of what those are, the criteria, etc.  I live in Chicago and drove the 5 hrs. to consult with him and then multiple times for surgeries and post-op visits (in fact, headed up there just yesterday for his take on things).  I too had severe patella pain...bilateral ACI was tried first and then when that didn't seem to help, they were going to do OATS.  Luckily a doc I was sent to for a consultation by my surgeon noticed the excessive femoral anteversion and that started my journey with Dr. Teitge. 

Her angles are great, as I'm sure you know based on the extensive amount of info Dr. Teitge provides.  I strongly feel that attempting to do any other surgery prior to the derotational osteotomies would be a waste and could potentially cause more harm than good (speaking from someone who had multiple surgeries before the true issue was pinpointed and then rectified).  The alignment needs to be corrected first, which could vary well alleviate the patella pain as the bones are hitting/rubbing where they should instead of where they are now due to the malalignment.  Granted, the derotational osteotomies may not be all that is needed but he does fix other things while he's in there (ie if he sees a torn ligament, etc.).  And maybe down the road when she is healed from these, she may need some type of cartilage surgery but Dr. Teitge can probably look at that as well (may not be able to fix it but could probably give you a better idea of what it looks like).

So my suggestion would be to go ahead with it now while she's younger and can rehab and recover faster.  I started my surgeries at the age of 26 and then every 3-12 months after that.  Each one has been a bit harder to rehab from and I'm sure age is a contributing factor.  And if nothing else, I would book a surgical date with him as I know he schedules way far out and then give it some more thought.  This way, if you decide to go for it, you have the date set and scheduled and if you change your mind, you can always call them and cancel.  Think the last time I checked, his wait list was anywhere from 9-12 months.  Not sure if it's still the same.

If you have anyquestions, please don't hesitate to ask!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline srosky

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Re: When to accept it is what it is.....
« Reply #9 on: October 19, 2012, 07:08:38 PM »
Teacher 2 many - thank you so much yes Dr. Tietge is booking a year out!! so I think we will book it & go from there!!! I still get confused about the angles.. He said she had hip internal rotation on the left 60 degrees right 70 degrees, external roatation 25 degrees, in prone position internal rotation 65-70 degrees & (I think) tibia was measured at 25 degrees does that make sense?? I wish I had scheduled the surgery right away but we were trying to find someone closer (so I wouldn't have to pay for a hotel so many medical bills which I'm sure everyone here has experienced) & someone who could do it sooner. She wants to start college ASAP!! Again thanks so much for your input I very much appreciate it, it was very helpful. Sue

Offline Teacher2Many

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Re: When to accept it is what it is.....
« Reply #10 on: October 19, 2012, 07:18:55 PM »
There is a hotel right down the street from Oakwood Heritage, which is where I'm assuming surgery will be done.  It's about a 5-10 minute drive.  It's a Comfort Inn & they offer hospital rates & is where my parents stayed (maybe $70/night).  There are many little places on that same stretch of road to eat or shop-my parents would stop at McDonalds around 11:30 pm on surgery night on the way back to the hotel, once I was settled & asleep in my room & then Walmart in the AM on the way to see me to bring me cute socks, etc.

And ask to get put on his waiting list-they'll call you if anyone cancels (which quite a few do)!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction

Offline Lyndsey

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Re: When to accept it is what it is.....
« Reply #11 on: October 22, 2012, 08:03:13 PM »
Hi Sue,

I have the utmost respect for Dr. Teitge, and if he believes the surgery will help, I would definitely go for it. Heck, I did go for it! And i'm glad I did. I still have some problems (hence this thread) but I am much better than I was before. It's all about what you're willing to do, and how you want to end up. Yes, surgery is a big deal, and Yes it is a painful process with a long recovery. BUT, you have to think of the rest of your life. For me, a couple years on the mend while i'm young was worth it to be better off for the rest of my life. I started college, even with the surgeries, but I took online classes so I could pace myself and didn't have to deal with the hustle and bustle of school while on crutches and healing. It worked out well.

Teacher2Many, Thanks for the advice and sharing your experience! I think you're right about consulting another doc that can check out my back and specifically my hip. Maybe we could actually get to the bottom of all this.


It has been a crazy packed week for me, and the craziness won't end until next week. I was at horse shows all weekend and giving riding instruction, and then this week we are preparing for another big horse show, along with going to work. I did well holding out and not taking anything for the pain in my hip all weekend, but today I gave in and took some Tylenol 3, because I just couldn't take it anymore, and I can't really take it easy yet. I have to get through this week and weekend, so some meds might be in order, but after that i'm going to have to limit my activity level so I can get back to normal. I just hate having to do this, and worry about the med use because I don't want to get dependent on them. :/
5/15/08      R femoral derotational osteotomy
1/19/09      L femoral derotational osteotomy
12/17/09  hardware removal (L&R femoral blade plates and screws)
10/28/10 removal of bone chip and cleanup of scar tissue on left
4/2014 15 deg. Re-rotation of L Femur
9/2014 L. Plate Removal & Fix Fracture

Offline srosky

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Re: When to accept it is what it is.....
« Reply #12 on: October 23, 2012, 03:19:07 PM »
Lyndsey - thanks so much for the advice...we will be following it hope everything works out for you too!!! Sue

Offline srosky

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Re: When to accept it is what it is.....
« Reply #13 on: December 19, 2012, 08:11:37 PM »
Well I took all of your advice & scheduled surgery with Dr. tietge - we got on a cancellation list received a call today & she will be having surgery 1/713!!! Teacher 2 many thanks for the advice on the hotel I will be calling them tomorrow!!! thanks to all who responded. Sue

Offline Teacher2Many

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Re: When to accept it is what it is.....
« Reply #14 on: December 20, 2012, 03:26:02 AM »
Awesome news and will be thinking of her and wishing her all the best!  The hospital staff is AMAZING as well as Dr. Teitge and his ortho crew.  Those first few weeks will be hard physically and emotionally but by the summer, she'll never look back with any regrets!
6/07-L TTT & LR
6/08-R TTT & LR
6/09-Bilateral ACI
7/10-R derotational femoral & tibial osteotomies, LPFL reconstruction
6/11-L derotational femoral & tibial osteotomies, R hardware removal
1/12-L tibial hardware removed, R scapulectomy
4/12-L femoral hardware removed
7/12-L & R MPFL reconstruction















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